Expandable vertebral body replacement device and method

ABSTRACT

An expandable vertebral body device, system, instrument, and methods of assembly and using the device, system, and instrument are disclosed. The vertebral body device includes a body with a first end and a second end, a first rotating member rotatably coupled to the first end, a second rotating member rotatably coupled to the second end, a first extension member moveably coupled to the first end, and a second extension member moveably coupled to the second end. The expandable cage system comprises a vertebral body device and an insertion instrument. Methods for assembling and using the vertebral body device and instrument are also disclosed.

CROSS REFERENCE TO RELATED APPLICATION

This application is a continuation application of U.S. application Ser.No. 16/847,320 filed Apr. 13, 2020 and entitled Expandable VertebralBody Replacement Device and Method, which is a continuation applicationof U.S. application Ser. No. 15/719,192 filed Sep. 28, 2017 and entitledExpandable Vertebral Body Replacement Device and Method, which is acontinuation application of U.S. application Ser. No. 14/665,833 filedMar. 23, 2015 and entitled Expandable Vertebral Body Replacement Deviceand Method, which are incorporated herein by reference in theirentireties.

FIELD OF THE INVENTION

The present invention relates generally to a medical implant forinsertion in a space between a patient's vertebrae. More specifically,but not exclusively, the present invention concerns expandable vertebralbody replacement devices for implantation in a patient's spine betweenthe vertebrae.

BACKGROUND OF THE INVENTION

Trauma or disease, such as, tumors may cause pressure on a patient'sspinal cord. In order to alleviate the pressure and likely the pain itis causing, surgeons may remove part or all of a patient's vertebralbodies and adjacent vertebral discs in the location of the pressure,during a procedure such as a corpectomy. Often implants are used toreplace the removed vertebral bodies to maintain the space between theremaining vertebral bodies.

SUMMARY OF THE INVENTION

Aspects of the present invention provide expanding vertebral bodyreplacement devices for implantation in a patient's spine between thevertebrae and methods of using the same.

In one aspect, provided herein is a vertebral body device, including abody with a first end and a second end, a first rotating memberrotatably coupled to the first end, a second rotating member rotatablycoupled to the second end, a first extension member moveably coupled tothe first end, and a second extension member moveably coupled to thesecond end.

In another aspect, provided herein is an expandable cage systemincluding a vertebral body device and an insertion instrument. Thevertebral body device including a body with a first end and a secondend, a first rotating member coupled to the first end, a second rotatingmember coupled to the second end, a first extension member moveablycoupled to the first end, and a second extension member moveably coupledto the second end. The body including a plurality of aperturespositioned around the body along a midpoint between the first end andthe second end, each of the plurality of apertures spaced apart from theadjacent apertures, a plurality of first positioning holes positionedsuperior to each of the plurality of apertures, and a plurality ofsecond positioning holes positioned inferior to each of the plurality ofapertures. The plurality of apertures, the plurality of firstpositioning holes, and the plurality of second positioning holes beingsized to receive the insertion instrument.

In yet another aspect, provided here is a method for using an expandablecage system, including obtaining a vertebral body device and aninsertion instrument. The vertebral body device including a body with afirst end and a second end, a first rotating member rotatably coupled tothe first end, a second rotating member rotatably coupled to the secondend, a first extension member moveably coupled to the first end, and asecond extension member moveably coupled to the second end. The methodalso includes coupling the vertebral body device to the insertioninstrument and inserting the vertebral body device into a patientbetween two vertebral bodies. The method further includes expanding thevertebral body device and removing the insertion instrument. Finally,the method includes closing the patient.

These, and other objects, features and advantages of this invention willbecome apparent from the following detailed description of the variousaspects of the invention taken in conjunction with the accompanyingdrawings.

BRIEF DESCRIPTION OF DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of the specification, illustrate embodiments of the invention andtogether with the detailed description herein, serve to explain theprinciples of the invention. The drawings are only for purposes ofillustrating preferred embodiments and are not to be construed aslimiting the invention. It is emphasized that, in accordance with thestandard practice in the industry, various features are not drawn toscale. In fact, the dimensions of the various features may bearbitrarily increased or reduced for clarity of discussion. Theforegoing and other objects, features and advantages of the inventionare apparent from the following detailed description taken inconjunction with the accompanying drawings in which:

FIG. 1 is a top perspective view of a vertebral body device, inaccordance with an aspect of the present invention;

FIG. 2 is a side view of the vertebral body device of FIG. 1 , inaccordance with an aspect of the present invention;

FIG. 3 is a cross-sectional view of the vertebral body device of FIG. 1taken along line 3-3 in FIG. 2 , in accordance with an aspect of thepresent invention;

FIG. 4 is an exploded side view of the vertebral body device of FIG. 1 ,in accordance with an aspect of the present invention;

FIG. 5 is an exploded perspective view of the vertebral body device ofFIG. 1 , in accordance with an aspect of the present invention;

FIG. 6 is a top perspective view of a body of the vertebral body deviceof FIG. 1 , in accordance with an aspect of the present invention;

FIG. 7 is a side view of the body of FIG. 6 , in accordance with anaspect of the present invention;

FIG. 8 is a perspective cross-sectional view of the body of FIG. 6 takenalong line 8-8 in FIG. 7 , in accordance with an aspect of the presentinvention;

FIG. 9 is a top view of the body of FIG. 6 , in accordance with anaspect of the present invention;

FIG. 10 is a cross-sectional view of the body of FIG. 6 taken along line10-10 in FIG. 9 , in accordance with an aspect of the present invention;

FIG. 11 is a top perspective view of a rotating member of the vertebralbody device of FIG. 1 , in accordance with an aspect of the presentinvention;

FIG. 12 is a top view of the rotating member of FIG. 11 , in accordancewith an aspect of the present invention;

FIG. 13 is a bottom view of the rotating member of FIG. 11 , inaccordance with an aspect of the present invention;

FIG. 14 is a side view of an extension member of the vertebral bodydevice of FIG. 1 , in accordance with an aspect of the presentinvention;

FIG. 15 is a top perspective view of the extension member of FIG. 14 ,in accordance with an aspect of the present invention;

FIG. 16 is a bottom perspective view of the extension member of FIG. 14, in accordance with an aspect of the present invention;

FIG. 17 is a bottom view of the extension member of FIG. 14 , inaccordance with an aspect of the present invention;

FIG. 18 is a perspective view of an insertion tool for the vertebralbody device of FIG. 1 , in accordance with an aspect of the presentinvention;

FIG. 19 is a side view of the insertion tool of FIG. 18 , in accordancewith an aspect of the present invention;

FIG. 20 is a front view of the insertion tool of FIG. 18 in a firstposition, in accordance with an aspect of the present invention;

FIG. 21 is a front view of the insertion tool of FIG. 18 in a secondposition, in accordance with an aspect of the present invention;

FIG. 22 is an exploded view of the insertion tool of FIG. 18 from afirst end, in accordance with an aspect of the present invention;

FIG. 23 is an exploded view of the insertion tool of FIG. 18 from asecond end, in accordance with an aspect of the present invention;

FIG. 24 is a perspective view of a vertebral body device systemincluding the vertebral body device of FIG. 1 and the insertion tool ofFIG. 18 , in accordance with an aspect of the present invention;

FIG. 25 is a perspective side view of a portion of the system of FIG. 24with a rod of the tool engaging the vertebral body device, in accordancewith an aspect of the present invention;

FIG. 26 is a perspective side view of the system of FIG. 24 with a rodof the tool engaging the vertebral body device, in accordance with anaspect of the present invention;

FIG. 27 is a perspective side view of the system of FIG. 24 with thetool engaging the vertebral body device in a first position, inaccordance with an aspect of the present invention;

FIG. 28 is a perspective side view of the system of FIG. 24 with thefirst extension member in a deployed position, in accordance with anaspect of the present invention;

FIG. 29 is a perspective side view of the system of FIG. 24 with the rodof the tool engaging the vertebral body device in a first position, inaccordance with an aspect of the present invention;

FIG. 30 is a perspective side view of the system of FIG. 24 with the rodof the tool engaging the vertebral body device in a second position, inaccordance with an aspect of the present invention;

FIG. 31 is a perspective side view of the system of FIG. 24 with thetool engaging the vertebral body device in a second position, inaccordance with an aspect of the present invention;

FIG. 32 is a perspective side view of the system of FIG. 24 with thesecond extension member in a deployed position, in accordance with anaspect of the present invention;

FIG. 33 is a perspective side view of the system of FIG. 24 with thetool removed from the expanded vertebral body device, in accordance withan aspect of the present invention;

FIG. 34 is a partially exploded, perspective top view of anothervertebral body device, in accordance with an aspect of the presentinvention;

FIG. 35 is a partially exploded, perspective bottom view of thevertebral body device of FIG. 34 , in accordance with an aspect of thepresent invention;

FIG. 36 is an assembled, side view of the vertebral body device of FIG.34 , in accordance with an aspect of the present invention;

FIG. 37 is a perspective top view of a first extension member of thevertebral body device of FIG. 34 , in accordance with an aspect of thepresent invention;

FIG. 38 is a perspective bottom view of the first extension member ofFIG. 37 , in accordance with an aspect of the present invention;

FIG. 39 is a perspective top view of an end cap of the vertebral bodydevice of FIG. 34 , in accordance with an aspect of the presentinvention;

FIG. 40 is a perspective bottom view of the end cap of FIG. 39 , inaccordance with an aspect of the present invention;

FIG. 41 is a side view of the end cap of FIG. 39 , in accordance with anaspect of the present invention;

FIG. 42 is a perspective side view of a first locking member, inaccordance with an aspect of the present invention;

FIG. 43 is a front view of the first locking member of FIG. 42 , inaccordance with an aspect of the present invention;

FIG. 44 is a side view of the first locking member of FIG. 42 , inaccordance with an aspect of the present invention;

FIG. 45 is a perspective back view of the first locking member of FIG.42 , in accordance with an aspect of the present invention;

FIG. 46 is a partially exploded, perspective side view of a vertebralbody device and the locking member of FIG. 42 , in accordance with anaspect of the present invention;

FIG. 47 is an assembled, perspective side view of the vertebral bodydevice and locking member of FIG. 46 with transparent rotating members,in accordance with an aspect of the present invention;

FIG. 48 is an assembled, perspective top view of the vertebral bodydevice and locking member of FIG. 46 , in accordance with an aspect ofthe present invention;

FIG. 49 is a cross-sectional view of the vertebral body device andlocking member of FIG. 46 taken along line 49-49 in FIG. 48 , inaccordance with an aspect of the present invention;

FIG. 50 is a perspective front view of a second locking member, inaccordance with an aspect of the present invention;

FIG. 51 is a perspective back view of the second locking member of FIG.50 , in accordance with an aspect of the present invention;

FIG. 52 is a front view of the second locking member of FIG. 50 , inaccordance with an aspect of the present invention;

FIG. 53 is a side view of the second locking member of FIG. 50 , inaccordance with an aspect of the present invention;

FIG. 54 is a partially exploded, perspective side view of a vertebralbody device and the locking member of FIG. 50 , in accordance with anaspect of the present invention;

FIG. 55 is an assembled, perspective side view of the vertebral bodydevice and locking member of FIG. 54 , in accordance with an aspect ofthe present invention; and

FIG. 56 is a front view of the vertebral body device and locking memberof FIG. 54 , in accordance with an aspect of the present invention.

DETAILED DESCRIPTION FOR CARRYING OUT THE INVENTION

Generally stated, disclosed herein is an expandable vertebral bodyreplacement device. Further, methods of assembling and using theexpandable vertebral body replacement device are discussed.

In this detailed description and the following claims, the wordsproximal, distal, anterior, posterior, medial, lateral, superior,inferior, cephalad, and caudal are defined by their standard usage forindicating a particular part of a bone or implant according to therelative disposition of the natural bone or directional terms ofreference. For example, “proximal” means the portion of an implantnearest the insertion instrument, while “distal” indicates the portionof the implant farthest from the insertion instrument. As fordirectional terms, “anterior” is a direction towards the front side ofthe body, “posterior” means a direction towards the back side of thebody, “medial” means towards the midline of the body, “lateral” is adirection towards the sides or away from the midline of the body,“superior” means a direction above, “inferior” means a direction belowanother object or structure, “cephalad” means a direction toward thehead, and “caudal” means a direction toward the inferior part of thebody.

Referring to the drawings, wherein like reference numerals are used toindicate like or analogous components throughout the several views, andwith particular reference to FIGS. 1-5 , there is illustrated anexemplary embodiment of an expandable vertebral body replacement device100. The terms “expandable vertebral body replacement device,”“vertebral body device,” “device,” “expandable cage,” and “cage” may beused interchangeably herein as they essentially describe the same typeof device. The vertebral body device 100 may include a body 110, a firstrotating member 130 rotatably coupled to the first end 112 of the body110, a second rotating member 140 rotatably coupled to the second end114 of the body 110, a first extension member 150 moveably coupled to afirst end 112 of the body 110, and a second extension member 170moveably coupled to a second end 114 of the body 110.

As shown in FIGS. 5, 6, and 8-10 , the body 110 may include an opening116 extending from the first end 112 to the second end 114, for example,along the longitudinal axis of the body 110. The opening 116 may includeat least two channels 118, 119 extending into the body 110 from theopening 116. At least one first channel 118 may extend from the firstend 112 toward the second end 114 and at least one second channel 119may extend from the second end 114 toward the first end 112. Thechannels 118, 119 may be, for example, evenly spaced around the opening116. As shown, the body 110 may include, for example, three firstchannels 118 open on the first end 112 and three second channels 119open on the second end 114. The channels 118, 119 may be spaced evenlyapart around the circumference of the opening and may alternate betweena first channel 118 and a second channel 119, as shown in FIG. 8 .Alternative numbers of channels 118, 119 are also contemplated, forexample, the body 110 may include the same number of first channels 118and second channels 119, more first channels 118 than second channels119, or more second channels 119 than first channels 118.

The exterior surface of the body 110 may further include a first groove120 near the first end 112 and a second groove 122 near the second end114, as shown in FIGS. 4-7 and 10 . The first and second grooves 120,122 may extend around the circumference of the body 110 and be sized toreceive the first and second rotating members 130, 140, respectively.The first groove 120 may extend into the first channels 118 to enablethe first rotating member 130 to engage the first extension member 150and the second groove 122 may extend into the channels 119 to enable thesecond rotating member 140 to engage the second extension member 170. Asshown in FIGS. 1-8 and 10 , the body 110 may also include a plurality ofapertures 124 positioned around the circumference of the exteriorsurface. The plurality of apertures 124 may be positioned, for example,at a midpoint between the first end 112 and second end 114 of the body110. The plurality of apertures 124 may be, for example, threadedopenings. The body 110 may also include a plurality of first positioningholes 126 superior to the plurality of apertures 124 and a plurality ofsecond positioning holes 128 inferior to the plurality of apertures 124.

The first rotating member 130 is shown in FIGS. 1-2, 4-5, and 11-13 .The first rotating member 130 may include a center opening 134 extendingthrough the first rotating member 130. The exterior surface of the firstrotating member 130 may include a plurality of grooves, notches, gearteeth, teeth, or scallops 132, as best seen in FIGS. 11 and 13 . Theplurality of grooves 132 may be, for example, sized to receive aninsertion tool, such as tool 200 described in greater detail below. Thefirst rotating member 130 may also include threads 136 on the interiorsurface of the member 130, as shown in FIGS. 5 and 11 . In addition, thefirst rotating member 130 may include at least one angled slot 138 toreceive a portion of the first extension member 150, as shown in FIGS.11-13 .

The second rotating member 140, as shown in FIGS. 4 and 5 , may includea plurality of grooves 142, a center opening 144, threads 146, andangled slots 148. The plurality of grooves 142, center opening 144,threads 146, and angled slots 148 may be of the type described abovewith reference to the plurality of grooves 132, center opening 134,threads 136, and angled slots 138 of first rotating member 130, whichwill not be described again here for brevity sake.

As shown in FIGS. 4-5 and 14-17 , the first extension member 150 mayinclude a first end 152 and a second end 154. The first extension member150 may also include a top portion or first end cap 156 at the first end152 and at least one leg member 162 extending away from the top portion156 and to the second end 154. The top portion 156 may include a curvedtop surface 158, for example, a hemispherical or cylindrical shaped cup,and a center opening 160, as shown in FIGS. 5 and 15 . The curved topsurface 158 and center opening 160 may be configured to receiveautologous bone graft or allograft material which will contact and allowfor fusion with the adjacent vertebral bodies and additional graftmaterial positioned between the at least one leg member 162. The curvedsurface 158 may be, for example, sized to allow the graft material to bepositioned within the first extension member 150 to minimize the height.In addition, the hemispherical shaped cup may be selected, for example,to minimize the amount of graft material necessary to fill the curvedsurface 158. The top surface 158 may be, for example, coated, textured,porous, or of a trabecular metal nature to allow for bone growth intothe first extension member 150 after implantation. In an alternativeembodiment, it is also contemplated that the curved top surface 158 maybe, for example, a mesh or open slotted top surface to allow for thebone graft material positioned in the top portion 156 to make contactwith bone graft material positioned between the at least one leg member162. The top portion 156 may also be configured to receive, for example,end caps (not shown) with lordosis or a larger footprint to contactlarger adjacent vertebral bodies at the outer ring of their end plates.

The at least one leg member 162 may be, for example, three leg members162. The leg members 162 may include threads 164 on an exterior surfaceand a tab 166 positioned at the second end 154 of the first extensionmember 150. The second end 154 of the leg members 162 may be, forexample, tapered or angled and the tab 166 may be positioned at the tipof the tapered or angled end. The tabs 166 may be sized and shaped toengage the angled slots 138 on the interior surface of the firstrotating member 130. As the tabs 166 are translated within the slots 138of the first rotating member 130, the threads 164 of the leg members 162engage the interior threads 136 of the first rotating member 130 tocouple the first extension member 150 to the first rotating member 130.The leg members 162 may be curved to enable the leg members 162 torotate with respect to the first rotating member 130. The firstextension member 150 may also include support members 168 positionedbetween and connected to the leg members 162. The support members 168may be, for example, cross-hatching braces positioned in rings. Asdepicted in FIGS. 14-17 , the support members 168 may, for example,extend out from the back side of the leg members 162 and be connectedbetween the leg members 162 in crisscross or “X” shaped arrangements.The crisscross arrangement of the leg members 162 may be, for example,curved between the leg members 162 to form a ring-like shape.

The second extension member 170, as shown in FIGS. 4 and 5 , may includea first end 172 and a second end 174. The second extension member 170may also include a bottom portion or second end cap 176 at the first end172 and at least one leg member 182 extending away from the bottomportion 176 and to the second end 174. The bottom portion 176 mayinclude a curved bottom surface 178 and an opening 180. The curvedbottom surface 178 may be of the type described above with respect tothe curved top surface 158, which will not be described again here forbrevity sake. The curved bottom surface 178 and center opening 180 mayalso be configured to receive autologous bone graft or allograftmaterial as described in greater detail above with respect to the firstextension member 150.

The at least one leg member 182 may be, for example, three leg members182 and may include threads 184, tabs 186, and support members 188. Thethreads 184, tabs 186, and support members 188 may be of the typedescribed above with reference to threads 164, tabs 166, and supportmembers 168, which will not be described again here for brevity sake.The tabs 186 may be sized and shaped to engage the angled slots 148 onthe interior surface of the second rotating member 140. As the tabs 186are translated within the slots 148 of the second rotating member 140,the threads 184 of the leg members 182 engage the interior threads 146of the first rotating member 140 to couple the second extension member170 to the second rotating member 140. The leg members 182 may be curvedto enable the leg members 182 to rotate with respect to the secondrotating member 140.

The vertebral body replacement device 100 may be assembled by obtaininga body 110 with a first rotating member 130 positioned in the firstgroove 120 and a second rotating member 140 positioned in the secondgroove 122. Next, the first and second extension members 150, 170 may beinserted into the channels 118 in the opening 116 of the body 110. Thefirst extension member 150 may be inserted into the channels 118 fromthe first end 112. During insertion into the channels 118, the tabs 166of the first extension member 150 may be aligned with the angled slots138 on the interior surface of the first rotating member 130. The tabs166 may be translated within the angled slots 138 by rotating the firstextension member 150 until the threads 164 of the leg members 162 engagethe interior threads 136 of the first rotating member 130. The firstextension member 150 may be rotated until the member 150 engages thefirst end 112 of the body 110. Once the first extension member 150 ispositioned in the body 110, then, the second extension member 170 may beinserted into the opening 116. The second extension member 170 may beinserted into the channels 119 from the second end 114. During insertioninto the channels 119, the tabs 186 of the second extension member 170may be aligned with the angled slots 148 on the interior surface of thesecond rotating member 140. The tabs 186 may be translated within theangled slots 148 by rotating the second extension member 170 until thethreads 184 of the leg members 182 engage the interior threads 146 ofthe second rotating member 140. The second extension member 170 may berotated until the member 170 engages the second end 114 of the body 110.

Referring now to FIGS. 18-23 , an insertion instrument or inserter tool200 is shown. The tool 200 includes a first end 202 and a second end204. The tool 200 may include a deployment handle 210 at the first end202, a position selector member 220 rotatably coupled to the handle 210,a rod 240 extending through the member 220, an implant attachment member250 coupled to a portion of the rod 240, and a tension adjustment member260 at the second end 204 and rotatably coupled to the rod 240.

As shown in FIGS. 22 and 23 , the deployment handle 210 may include apassageway 212 extending along the longitudinal axis of the handle 210from a first end to a second end. The handle 210 may also include a neck214 near the first end. The neck 214 may, for example, increase thediameter of the handle from a body portion 215 to the engagement end216. The engagement end 216 may include a plurality of projections 218for engaging the grooves 132, 142 in the rotating members 130, 140. Theplurality of projections 218 may be, for example, cone shaped or angledtoward the point of attachment with the handle 210 to allow for theprojections 218 to engage the grooves or teeth 132, 142 of the rotatingmembers 130, 140. The teeth 132, 142 may have, for example, an undercutor angled shape to lock the plurality of projections 218 into the teeth132, 142 and prevent jumping of the projections 218 with respect to theteeth 132, 142 as the handle 210 is rotated.

The position selector member 220 may include a first portion 222, asecond portion 224, and an opening 226 extending through the entiremember 220, as shown in FIGS. 22 and 23 . The opening 226 may be offsetfrom the center of the member 220 and extend in a longitudinaldirection. The opening 226 may be configured to receive the rod 240. Thefirst portion 222 may also have, for example, a smaller diameter thanthe second portion 224. The first portion 222 may be sized to fit in thepassageway 212 of the handle 210. The first portion 222 may furtherinclude a pin 228 extending away from a first end of the first portion222. The pin 228 may be shaped and sized to fit in the first and secondpositioning holes 126, 128 of a vertebral body device 100. In addition,the first portion 222 may include a plurality of grooves 230 positionedaround the exterior surface. The second portion 224 may include aplurality of holes 232 extending through the second portion 224 in alongitudinal direction and aligning with the grooves 230 in the firstportion 222. The second portion 224 may also include a flange 234surrounding the opening 226. The flange 234 may be configured or sizedand shaped to be received within the attachment member 250.

FIGS. 22 and 23 show the rod 240. The rod 240 includes a threadedsection 242 at a first end and a cutout portion 244 and a threadedportion 246 at a second end. The threaded portion 246 may extend alongthe rod 240, for example, a shorter, the same, or a longer distance thanthe length of the cutout portion 244. The cutout portion 244 may be, forexample, a flat or planar portion of the circular rod 240. The rod 240may be inserted into the opening 226 in the position selector member 220and extend out the first end 202 of the tool 200.

The implant attachment member 250, as shown in FIGS. 22 and 23 , mayinclude an opening 252 which may be shaped, for example, to receive thecutout portion 244. The opening 252 may include, for example, a planarportion and a circular portion to correspond to the planar section andcircular section of the cutout portion 244 of the rod 240. The opening252 may extend through the member 250 in a longitudinal direction. Aflange 254 may be positioned around the opening 252 at a first end ofthe member 250. The second end of the member 250 may include a couplingcavity 258 recessed within the member 250. The cavity 258 may be sizedto receive the flange 234 extending away from the position selectormember 220 to rotatably couple the implant attachment member 250 to theposition selector member 220. The attachment member 250 may also includea grooved exterior surface 256. The grooved surface 256 may, forexample, assist the user with turning the member 250.

Referring to FIGS. 22 and 23 , the tension adjustment member 260includes an opening 262 extending through the member 260 in alongitudinal direction. The opening 262 may be threaded with threadscorresponding to the threads 246 on the rod 240. As shown in FIG. 22 ,the adjustment member 260 may also include a coupling cavity 264 whichis configured or sized and shaped to receive the flange 254 of theattachment member 250 to rotatably couple the attachment member 250 tothe adjustment member 260. Further, the adjustment member 260 may have atextured surface 266 on the exterior of the adjustment member 260 toassist with rotation of the member 260 during use.

With continued reference to FIGS. 18-23 , the inserter tool 200 may beassembled by inserting the first portion 222 of the position selectormember 220 into the opening 212 in the handle 210. The position selectormember 220 may be inserted with the pin 228 in a superior or inferiorposition. Next, the rod 240 may be inserted into the opening 226 in thesecond portion 224 of the position selector member 220. The opening 252of the attachment member 250 may be aligned with the cutout portion 244of the rod 240 and the attachment member 250 may be inserted over therod 240. The attachment member 250 may be translated down the rod 240until it engages the second portion 224 of the position selector member220. Finally, the adjustment member 260 may be threaded onto the threads246 of the rod 240 until the adjustment member 260 engages theattachment member 250.

Referring now to FIGS. 24-33 with continued reference to FIGS. 1-23 , amethod of using the vertebral body device 100 and insertion instrument200 is shown. The method includes obtaining a vertebral body device 100and an insertion instrument 200. The vertebral body 100 and insertioninstrument 200 may be assembled as described in greater detail above,which will not be described again here for brevity sake. The instrument200 may then be coupled to the vertebral body device 100 by aligning thethreaded section 242 of the rod 240 with one of the plurality ofopenings 124, as shown in FIG. 24 .

Once aligned the attachment member 250 may be rotated to turn the rod240 and engage the threaded section 242 with the threads in the selectedopening 124, as shown in FIGS. 25 and 26 . The attachment member 250 maybe, for example, rotated in a clockwise direction to engage the threadedopening 124. Next, the adjustment member 260 may be rotated to translatethe deployment handle 210, the position selector member 220, theattachment member 250, and the adjustment member 260 toward the threadedsection 242 of the rod 240. The adjustment member 260 translates by thethreads in opening 262 engaging the threaded portion 242 of the rod 240.As the adjustment member 260 is rotated the pin 228 is also movedrelative to the rod 240 to engage one of the first positioning holes 126or one of the second positioning holes 128. The pin 228 is shownpositioned in a first positioning hole 126 in FIG. 27 . FIG. 21illustrates the pin 228 in a position to engage one of the firstpositioning holes 126 and FIG. 20 illustrates the pin 228 in a positionto engage one of the second positioning holes 128. In addition, asadjustment member 260 is rotated, the plurality of projections 218 onthe handle 210 are moved into engagement with the plurality of grooves132, 142 on the first or second rotating member 130, 140. As shown inFIG. 28 , the plurality of projections 218 engage the grooves 132 on thefirst rotating member 130.

After the pin 228 is positioned in a first positioning hole 126 andprojections 218 are positioned in the grooves 132 of the first rotatingmember 130, the handle 210 may be rotated. As the handle 210 is rotatedthe projections 218 engage the grooves 132 to rotate the first rotatingmember 130. As the first rotating member 130 spins, the first extensionmember 150 may translate in a superior-inferior direction. As shown inFIG. 28 , if the handle 210 is rotated in a clockwise direction, therotating member 130 will spin in a counterclockwise direction, and thefirst extension member 150 will translate in a superior directionincreasing the height of the vertebral body device 100. Alternatively,if the handle 210 is rotated in a counterclockwise direction, therotating member 130 will spin in a clockwise direction, and the firstextension member 150 will translate in an inferior direction decreasingthe height of the vertebral body device 100. The amount ofsuperior-inferior translation is limited by the length of the legmembers 162.

Once the first extension member 150 is deployed to a desired position,the adjustment member 260 may be rotated in, for example, acounterclockwise direction to disengage the projections 218 from thegrooves 132 and the pin 228 from the first positioning hole 126, asshown in FIG. 29 . Next, the second extension member 170 may be deployedto a desired position. To deploy the second extension member 170, theposition of the pin 228 may be moved to an inferior position. The pin228 may be moved by holding the attachment member 250 and simultaneouslyrotating the position selector member 220 to rotate the pin 228 to aninferior position, as shown in FIG. 30 . The position selector member220 may be rotated in a counterclockwise direction to rotate the pin 228from a superior position to an inferior position and vice versa. The pin228 may be rotated until it is aligned with one of the secondpositioning holes 128.

Next, the adjustment member 260 may be rotated to again translate thedeployment handle 210, the position selector member 220, the attachmentmember 250, and the adjustment member 260 toward the threaded section242 of the rod 240. The adjustment member 260 may be rotated until thepin 228 engages a second positioning hole 128 and the projections 218engage the grooves 142 in the second rotating member 140, as shown inFIG. 31 . The handle 210 may then be rotated to engage the projections218 in the grooves 132 causing the second rotating member 140 to turn.As the second rotating member 140 spins, the second extension member 170may translate in a superior-inferior direction. As shown in FIG. 32 , ifthe handle 210 is rotated in a clockwise direction, the rotating member140 will spin in a clockwise direction, and the second extension member170 will translate in an inferior direction increasing the height of thevertebral body device 100. Alternatively, if the handle 210 is rotatedin a counterclockwise direction, the rotating member 140 will spin in acounterclockwise direction, and the second extension member 170 willtranslate in a superior direction decreasing the height of the vertebralbody device 100. The amount of superior-inferior translation is limitedby the length of the leg members 182. Once the desired configuration andheight of the vertebral body device 100 is achieved, the attachmentmember 250 may be rotated to disengage the thread section 242 from theopening 124. After the rod 240 is removed from the vertebral body device100, the instrument 200 may be removed from the implant 100, as shown inFIG. 33 .

Another expandable vertebral body replacement device 300 is shown inFIGS. 34-36 . The device 300 includes a body 110, a first rotatingmember 130, a second rotating member 140, a first extension member 310,a second extension member 340, and an end cap 370. The body 110, firstrotating member 130, and second rotating member 140 are as describedabove with reference to FIGS. 1-13 , which will not be described againhere for brevity sake. The first extension member 310 is shown in FIGS.35, 37, and 38 . The first extension member 310 includes a first end 312and a second end 314. The first extension member 310 may also include atop portion 316 at the first end 312 and at least one leg member 326extending away from the top portion 316 and to the second end 314. Thetop portion 316 may include a curved top surface 318, for example, ahemispherical or cylindrical shaped cup. The top portion 316 may alsoinclude a center opening 320, a plurality of grooves 322, and aplurality of openings 324. The plurality of grooves 322 may be, forexample, inset into the top surface 318 and surrounding the centeropening 320. The plurality of openings 324 may, for example, extendthrough the top portion 316 from the top surface 318 entirely throughthe top portion 316 and may surround the center opening 320. The topsurface 318 and center opening 320 may be, for example, configured toreceive an end cap 370 with lordosis or a larger footprint to contactlarger adjacent vertebral bodies at the outer ring of their end plates.The center opening 320 may also be configured to receive autologous bonegraft or allograft material which will contact and allow for fusion withthe adjacent vertebral bodies and additional graft material positionedbetween the at least one leg member 326.

The at least one leg member 326 may be, for example, three leg members326, as shown in FIGS. 35, 37, and 38 . The leg members 326 may includethreads 328 on an exterior surface, a tab 330 on each leg member 326positioned at the second end 314 of the first extension member 310, andsupport members 332 positioned between and connected to the leg members326. The leg members 326 may be of the type described above with respectto leg members 162, 182, which will not be described again here forbrevity sake.

The second extension member 340 is similar to the first extension member310 of FIGS. 37 and 38 . As shown in FIG. 35 , the second extensionmember 340 may include a first end 342 and a second end 344. The secondextension member 340 may also include a bottom portion 346 at the firstend 342 and at least one leg member 356 extending away from the bottomportion 346 and to the second end 344. The bottom portion 346 mayinclude a curved bottom surface 348, for example, a hemispherical orcylindrical shaped cup. The bottom portion 346 may also include a centeropening 350, a plurality of grooves 352, and a plurality of openings354. The plurality of grooves 352 may be, for example, inset into thebottom surface 348 and surrounding the center opening 350. The pluralityof openings 354 may, for example, extend through the bottom portion 346from the bottom surface 348 entirely through the bottom portion 346 andmay surround the center opening 350. The bottom surface 348 and centeropening 350 may be, for example, configured to receive an end cap 370with lordosis or a larger footprint to contact larger adjacent vertebralbodies at the outer ring of their end plates. The center opening 350 mayalso be configured to receive autologous bone graft or allograftmaterial which will contact and allow for fusion with the adjacentvertebral bodies and additional graft material positioned between the atleast one leg member 356.

The at least one leg member 356 may be, for example, three leg members356. The leg members 356 may include threads 358 on an exterior surface,a tab 360 on each leg member 356 positioned at the second end 344 of thesecond extension member 340, and support members 362 positioned betweenand connected to the leg members 356. The leg members 356 may be of thetype described above with respect to leg members 162, 182, which willnot be described again here for brevity sake.

As shown in FIGS. 39-41 , the end cap 370 may include a top surface 372,a bottom surface 376, and an opening 378 extending through the end cap370 from the top surface 372 to the bottom surface 376. The top surface372 may have a textured surface 374, for example, grooves, teeth,ridges, or another coated, textured, or porous surface. The end cap 370may also include an engagement portion 380 extending away from thebottom surface 376 and configured to engage at least one of the firstand second extension members 310, 340. The engagement portion 380 mayinclude teeth 382 positioned around the opening 378 and sized to fitinto the grooves 322, 352 of the first and second extension members 310,340. The engagement portion 380 may also include at least one engagementmember 384 extending away from the bottom surface 376. The at least oneengagement member 384 may be coupled to the bottom edge of the opening378 at a first end. The at least one engagement member 384 may be, forexample, five engagement members 384 as shown in FIGS. 35 and 40 .Although alternative numbers of engagement members 384 are alsocontemplated. The engagement members 384 may be positioned, for example,circumferentially around the opening 378 and be sized to fit into theopenings 320, 350 of the first and second extension members 310, 340.Each engagement member 384 may include a projection 386 at the secondend extending away from the opening 378. The projections 386 may besized and shaped to engage the top portion 316 of the first extensionmember 310 or the bottom portion 346 of the second extension member 340.The projections 386 may engage a bottom surface of the top portion 316of the first extension member 310 and/or a top surface the bottomportion 346 of the second extension member 340 to secure the end cap 370to at least one of the first extension member 310 and second extensionmember 340. Although the end cap 370 is shown with a relativelyrectangular shape, the end cap 370 may have any shape desired tocorrespond to the shape of the vertebral body being contacted by the endcap 370.

The vertebral body replacement device 300 may be assembled as describedin greater detail above with respect to vertebral body replacementdevice 100 and which will not be described again here for brevity sake.Assembly of the device 300 may also include inserting the engagementmembers 384 of the end cap 370 into the opening 320, 350 of at least oneof the first and second extension members 310, 340. The method of usingthe device 300 may be the same or similar to the method of using thedevice 100 and may include use of the insertion instrument 200, asdescribed in greater detail above and which will not be described againhere for brevity sake.

The expandable vertebral body replacement devices 100, 300 may alsoinclude a locking member, for example, locking member 400 shown in FIGS.42-49 or locking member 450 shown in FIGS. 50-56 . As shown in FIGS.42-45 , the locking member 400 may include a base 402 with at least oneopening 404 positioned on a side of the base and a first recess 406 anda second recess 408 positioned on the front of the base 402. The atleast one opening 404 may be, for example, four openings 404 with twoopenings 404 positioned on opposite sides, near a top of the base 402and two openings 404 positioned on opposite sides, near a bottom of thebase 402. The base 402 may also include a hole 418 for receiving acoupling member 410. The first recess 406 may be positioned above thehole 418 and the second recess 408 may be positioned below the hole 418.The recesses 406, 408 may be sized to engage an instrument for insertingthe locking member 400 into the patient to engage an expandablevertebral body replacement device 100, 300. The coupling member 410 mayinclude a tool opening 412 positioned on the front, at least one cutout414 on the side, and an engagement member 416 extending away from a backside. The engagement member 416 may be, for example, threaded to coupleto the threads in the insertion tool opening 124 of the body 110 of thedevices 100, 300. The tool opening 412 may be sized to receive a tool torotate the coupling member 410 to insert the engagement member 416 intothe opening 124 to secure the locking member 400 to the body 110. Thebase 402 may also include a first alignment projection 420 extendingaway from a back side of the base 402 and a second alignment projection422 extending away from the back side of the base 402. The firstalignment projection 420 may be positioned above the hole 418 and thesecond alignment projection 422 may be positioned below the hole 418.The first alignment projection 420 may be positioned to engage a firstpositioning hole 126 and the second alignment projection 422 may bepositioned to engage a second positioning hole 128 or vice versa.

The locking member 400 may also include a first wing member 430rotatably coupled to a top of the base 402 and a second wing member 440rotatably coupled to a bottom of the base 402. The first wing member 430may include a first hinge 432 and a second hinge 434 on a first end ofthe first wing member 430. The first hinge 432 may be positioned on afirst side of the wing member 430 and the second hinge 434 may bepositioned on a second side of the wing member 430 opposite the firstside. The first and second hinges 432, 434 may engage openings 404positioned near the top of the base 402. The first wing member 430 mayalso include, for example, a tapered end 436 positioned on a second endof the first wing member 430 opposite the first end. The tapered end 436may be sized to extend between the body 110 and one of the firstrotating member 130 and second rotating member 140, as shown in FIGS.47-49 . The second wing member 440 may include a first hinge 442 and asecond hinge 444 on a first end of the second wing member 440. The firsthinge 442 may be positioned on a first side of the wing member 440 andthe second hinge 444 may be positioned on a second side of the wingmember 440 opposite the first side. The first and second hinges 442, 444may engage openings 404 positioned near the bottom of the base 402. Thesecond wing member 440 may also include, for example, a tapered end 446positioned on a second end of the second wing member 440 opposite thefirst end. The tapered end 446 may be sized to extend between the body110 and one of the first rotating member 130 and second rotating member140, as shown in FIGS. 47-49 .

With continued reference to FIGS. 47-49 , once the device 300 is in thedesired position, a locking member 400 may be inserted to secure thedevice 300 in the desired position. The locking member 400 may beinserted by coupling the locking member 400 to an insertion tool (notshown) with the wing members 430, 440 in an angled position. The firstalignment projection 420 may be, for example, aligned with alignmentopening 126 and the second alignment projection 422 may be, for example,aligned with alignment opening 128. The projections 420, 422 of thelocking member 400 may then be inserted into the openings 126, 128 ofthe body 110, as shown in FIG. 47 . Then, a driver (not shown) may beinserted into the tool opening 412 and the coupling member 410 may berotated to secure the locking member 400 to the body 110. As thecoupling member 410 is rotated the wing members 430, 440 engage the sideof the body 110, the first wing member 430 may, for example, slidebetween the body 110 and the first rotating member 130 and the secondwing member 440 may slide between the body 110 and the second rotatingmember 140. The tapered ends 436, 446 of the wing members 430, 440 may,for example, act as wedges to secure the rotating members 130, 140 andprevent them from rotating in order to secure the extension members 310,340 in the desired position.

As shown in FIGS. 50-56 , the locking member 450 may include a body 452with a first recess 454, a second recess 456, and a hole 457. The firstand second recess 454, 456 may be positioned on the front of the body452. The hole 457 may be sized to receive a coupling member 470. Thefirst recess 454 may be positioned above the hole 457 and the secondrecess 456 may be positioned below the hole 457. The recesses 454, 456may be sized to engage an instrument for inserting the locking member450 into the patient to engage an expandable vertebral body replacementdevice 100, 300. The body 452 may also include a first alignmentprojection 458 extending away from a back side of the body 452 and asecond alignment projection 460 extending away from the back side of thebody 452. The first alignment projection 458 may be positioned above thehole 457 and the second alignment projection 460 may be positioned belowthe hole 457. The first alignment projection 458 may be positioned toengage a first positioning hole 126 and the second alignment projection460 may be positioned to engage a second positioning hole 128 or viceversa.

The body 542 may also include a first extension member 462 extendingaway from a top of the body 452 and a second extension member 466extending away from a bottom of the body 452. The first extension member462 may include a first channel 464 for engaging at least one groove132, 142 of a rotating member 130, 140 to secure the device 100, 300 inthe desired position. The second extension member 466 may include asecond channel 468 for engaging at least one groove 132, 142 of arotating member 130, 140 to secure the device 100, 300 in the desiredposition. The extension members 462, 466 may have, for example, agenerally triangular shape, although other shapes are also contemplated.

The coupling member 470 may include a tool opening 472 positioned on thefront and an engagement member 474 extending away from a back side. Theengagement member 474 may be, for example, threaded to couple to thethreads in the insertion tool opening 124 of the body 110 of the devices100, 300. The tool opening 472 may be sized to receive a tool to rotatethe coupling member 470. As the coupling member 470 is rotated theengagement member 474 is inserted into the opening 124 and the lockingmember 450 is secured to the body 110.

As shown in FIGS. 54-56 , once the device 300 is in the desiredposition, a locking member 450 may be inserted to secure the device 300in the desired position. The locking member 450 may be inserted bycoupling the locking member 450 to an insertion tool (not shown). Thefirst alignment projection 458 may be, for example, aligned withalignment opening 126 and the second alignment projection 460 may be,for example, aligned with alignment opening 128. The projections 458,460 of the locking member 450 may then be inserted into the openings126, 128 of the body 110, as shown in FIG. 55 . Next, a driver (notshown) may be inserted into the tool opening 472 and the coupling member470 may be rotated to secure the locking member 450 to the body 110. Asthe coupling member 470 is rotated the channels 464, 468 engage thegears 132, 142 of the first and second rotating members 130, 140. Atooth of the gears 132, 142 may be, for example, positioned within thechannels 464, 468 of the locking member 450 or the end of the lockingmember 450 with the channels 464, 468 may be positioned in the groove ofthe gears 132, 142 to secure the rotating members 130, 140 and lock thedevice 300 in the desired position.

The terminology used herein is for the purpose of describing particularembodiments only and is not intended to be limiting of the invention. Asused herein, the singular forms “a”, “an” and “the” are intended toinclude the plural forms as well, unless the context clearly indicatesotherwise. It will be further understood that the terms “comprise” (andany form of comprise, such as “comprises” and “comprising”), “have” (andany form of have, such as “has”, and “having”), “include” (and any formof include, such as “includes” and “including”), and “contain” (and anyform of contain, such as “contains” and “containing”) are open-endedlinking verbs. As a result, a method or device that “comprises,” “has,”“includes,” or “contains” one or more steps or elements possesses thoseone or more steps or elements, but is not limited to possessing onlythose one or more steps or elements. Likewise, a step of a method or anelement of a device that “comprises,” “has,” “includes,” or “contains”one or more features possesses those one or more features, but is notlimited to possessing only those one or more features. Furthermore, adevice or structure that is configured in a certain way is configured inat least that way, but may also be configured in ways that are notlisted.

The invention has been described with reference to the preferredembodiments. It will be understood that the architectural andoperational embodiments described herein are exemplary of a plurality ofpossible arrangements to provide the same general features,characteristics, and general system operation. Modifications andalterations will occur to others upon a reading and understanding of thepreceding detailed description. It is intended that the invention beconstrued as including all such modifications and alterations.

Having thus described the preferred embodiments, the invention is nowclaimed to be:
 1. A vertebral body device, comprising: a body with afirst end and a second end; a first rotating member rotatably coupled toan exterior surface of the first end; a second rotating member rotatablycoupled to an exterior surface of the second end; a first extensionmember moveably coupled to the first end; and a second extension membermoveably coupled to the second end.
 2. The vertebral body device ofclaim 1, further comprising: a locking member.
 3. The vertebral bodydevice of claim 2, the locking member further comprising: a plate; andat least one alignment projection.
 4. The vertebral body device of claim2, the locking member further comprising: a plate; and two alignmentprojections.
 5. The vertebral body device of claim 3, furthercomprising: at least one alignment hole adapted to receive the at the atleast one alignment projection.
 6. The vertebral body device of claim 4,further comprising: two alignment holes adapted to receive the twoalignment projections.
 7. The vertebral body device of claim 6, the bodyfurther comprising: an opening extending from the first end to thesecond end; at least one first channel recessed into an interior surfaceof the body and extending from the first end toward the second end andpositioned adjacent to the opening; and at least one second channelrecessed into the interior surface of the body and extending from thesecond end toward the first end and positioned adjacent to the opening.8. The vertebral body device of claim 7, the at least one first channelis three channels, the at least one second channel is three channels,and the first channels are each positioned adjacent to the secondchannels.
 9. The vertebral body device of claim 7, the body furthercomprising: a first groove positioned on the exterior surface of thebody near the first end for receiving the first rotating member; asecond groove positioned on the exterior surface of the body near thesecond end for receiving the second rotating member; at least oneaperture positioned at a midpoint between the first end and the secondend; at least one first positioning hole positioned superior to the atleast one aperture; and at least one second positioning hole positionedinferior to the at least one aperture.
 10. The vertebral body device ofclaim 9, the first rotating member comprising: a center opening formingan interior surface, the interior surface comprising: threads positionedon the interior surface; and at least one first angled slot positionedon the interior surface and intersecting the threads as the at least onefirst angled slot extends from a top surface to a bottom surface of thefirst rotating member; and a plurality of grooves positioned around anexterior surface of the first rotating member, the plurality of groovesare undercut toward the interior surface; and the second rotating membercomprising: a center opening forming an interior surface, the interiorsurface comprising: threads positioned on the interior surface; and atleast one second angled slot positioned on the interior surface andintersecting the threads as the at least one second angled slot extendsfrom a bottom surface to a top surface of the second rotating member;and a plurality of grooves positioned around an exterior surface of thesecond rotating member, the plurality of grooves are undercut toward theinterior surface.
 11. The vertebral body device of claim 10, the firstextension member comprising: a top portion; at least one first legmember extending away from the top portion; and at least one firstsupport member positioned between and coupled to the at least one firstleg member; and the second extension member comprising: a bottomportion; at least one second leg member extending away from the bottomportion; and at least one second support member positioned between andcoupled to the at least one second leg member.
 12. The vertebral bodydevice of claim 11, the at least one first leg member comprising:threads positioned on an exterior surface of the at least one first legmember and configured to engage the threads on the interior surface ofthe first rotating member; and a tab positioned on a second end of theat least one first leg member and configured to engage the at least onefirst angled slot of the first rotating member. the at least one secondleg member comprising: threads positioned on an exterior surface of theat least one second leg member and configured to engage the threads onthe interior surface of the second rotating member; and a tab positionedon a second end of the at least one second leg member and configured toengage the at least one second angled slot of the second rotatingmember.
 13. The vertebral body device of claim 11, the top portioncomprising: a center opening extending from a top surface to a bottomsurface of the top portion; and a plurality of grooves in the topsurface and positioned circumferentially around the center opening; andthe bottom portion comprising: a center opening extending from a bottomsurface to a top surface of the bottom portion; and a plurality ofgrooves in the bottom surface and positioned circumferentially aroundthe center opening.
 14. The vertebral body device of claim 7, eachchannel of the at least one first channel comprising: a first open endat the first end of the body; and a first closed end at the second endof the body; and each channel of the at least one second channelcomprising: a second open end at the second end of the body; and asecond closed end at the first end of the body; the first open ends ofthe at least one first channels are separated by the second closed endsof the at least one second channels and the second open ends of the atleast one second channels are separated by the first closed ends of theat least one first channels.
 15. The vertebral body device of claim 6,the first rotating member comprising: a center opening forming aninterior surface, the interior surface comprising: threads positioned onthe interior surface; and a plurality of grooves positioned around anexterior surface, the plurality of grooves are undercut toward theinterior surface; and the second rotating member comprising: a centeropening forming an interior surface, the interior surface comprising:threads positioned on the interior surface; and a plurality of groovespositioned around an exterior surface, the plurality of grooves areundercut toward the interior surface.
 16. The vertebral body device ofclaim 15, the first rotating member further comprising: at least onefirst angled slot positioned on the interior surface and intersectingthe threads on the first rotating member; and the second rotating memberfurther comprising: at least one second angled slot positioned on theinterior surface and intersecting the threads on the second rotatingmember.
 17. The vertebral body device of claim 16, the body comprising:an opening extending from the first end to the second end; at least onefirst channel extending from the first end toward the second end andpositioned adjacent to the opening; at least one second channelextending from the second end toward the first end and positionedadjacent to the opening; a first groove positioned near the first endfor receiving the first rotating member; a second groove positioned nearthe second end for receiving the second rotating member; and at leastone aperture positioned at a midpoint between the first groove and thesecond groove.
 18. The vertebral body device of claim 17, the firstextension member comprising: a top portion; at least one first legmember extending away from the top portion, the at least one first legmember comprising: threads positioned on an exterior surface of the atleast one first leg member and configured to engage the threads on theinterior surface of the first rotating member; and a tab positioned on asecond end of the at least one first leg member and configured to engagethe at least one first angled slot of the first rotating member; and atleast one first support member positioned between and coupled to the atleast one first leg member.
 19. The vertebral body device of claim 18,the second extension member comprising: a bottom portion; at least onesecond leg member extending away from the bottom portion, the at leastone second leg member comprising: threads positioned on an exteriorsurface of the at least one second leg member and configured to engagethe threads on the interior surface of the second rotating member; and atab positioned on a second end of the at least one second leg member andconfigured to engage the at least one second angled slot of the secondrotating member; and at least one second support member positionedbetween and coupled to the at least one second leg member.
 20. Thevertebral body device of claim 19, the top portion comprising: a centeropening extending from a top surface to a bottom surface of the topportion; and a plurality of grooves in the top surface and positionedcircumferentially around the center opening; and the bottom portioncomprising: a center opening extending from a bottom surface to a topsurface of the bottom portion; and a plurality of grooves in the bottomsurface and positioned circumferentially around the center opening.